A 57-year-old man presents with a blistering rash on his chest and upper arm. He reports that the blisters often erupt and are mildly pruritic. He denies oral lesions. Nikolsky sign is negative. Biopsy is performed which reveals linear immunofluorescence of the epidermal basement membrane. Which of the following is the underlying mechanism of this disease?Ask StudybuddyGroup of answer choicesIgG antibodies against desmosomesIgG antibodies against hemidesmosomesType IV hypersensitivity reaction following exposure to allergenDeposits of IgA at the tips of dermal papillae
Question
A 57-year-old man presents with a blistering rash on his chest and upper arm. He reports that the blisters often erupt and are mildly pruritic. He denies oral lesions. Nikolsky sign is negative. Biopsy is performed which reveals linear immunofluorescence of the epidermal basement membrane. Which of the following is the underlying mechanism of this disease?Ask StudybuddyGroup of answer choicesIgG antibodies against desmosomesIgG antibodies against hemidesmosomesType IV hypersensitivity reaction following exposure to allergenDeposits of IgA at the tips of dermal papillae
Solution
The underlying mechanism of the disease presented in the question is IgG antibodies against hemidesmosomes.
Here's a step-by-step explanation:
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The patient's symptoms and the biopsy results suggest a condition known as Bullous Pemphigoid. This is a blistering skin disease that primarily affects older adults.
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Bullous Pemphigoid is an autoimmune disease. This means that the body's immune system mistakenly attacks healthy cells, in this case, in the skin.
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The attack is carried out by a type of antibody known as Immunoglobulin G (IgG).
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In Bullous Pemphigoid, these IgG antibodies specifically target hemidesmosomes. Hemidesmosomes are structures that help attach the epidermis (the outer layer of skin) to the dermis (the layer of skin beneath the epidermis).
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When the IgG antibodies attack the hemidesmosomes, it causes inflammation and blistering of the skin, which are the symptoms the patient is experiencing.
So, the underlying mechanism of this disease is IgG antibodies against hemidesmosomes.
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